ENTRY BLANK
O
! o-u
PLEASE TYPE OR PRINT
T^Ms.
□ Mr. Artist
un rniiN i
y>ni h'lCAtib
(Last Name Last)
Ckl /L
Street City
yw Daytime Tel. ( )
Area Code
Permanent
Address _
Zip
Temporary or
Studio Address.
Street
City
Daytime Tel. ( )
Zip Area Code
If you do not presently live in one of the counties of the
Western Reserve, in which county were you born?
Collaborator
(If Any)
If May Show entries are not accepted or not sold:
^ Artist will pick up at Museum.
□ Museum should dispose of.
□ Museum should ship to artist at artist’s expense
to this address:
Special Instructions
When necessary include below instructions or a drawing of how
the object is to be assembled and displayed.
This Entry Blank must be fully made out and signed. Unsigned
Entry Blanks will not be accepted.
Note carefully calendar for delivery and return of objects. It is
understood that the Museum will have the right to dispose for
its own account any objects not called for by the dates listed.
It is also understood that accepted objects will remain on
exhibition until July 21, 1985.
The submission of objects will be construed as an acceptance
by the artist of all terms and conditions printed in the
Entry Information^ /I t /
'/
Signature
latio/v /»
7 %^' M,
DETACH
ENTRY BLANKS
1
□ 1. Paintings □ 2. Graphics j%3. Photography
□ 4. Sculpture □ 5. Crafts
Materials
AH' -y
fiAMP's &/2K>kArrin
Title
Price or NFS
Insurance Value
Size
ZDC&
if NFS Only
20 xp~</
Additional No.
Total No. in Edition
Price of
For Sale .
Unframed
Frame
ip
ZO
ill
IS 0 "
ACCEPTED
REJECTED
DO NOT WRITE IN THIS SECTION
<? a
ACCEPTED
□ 1. Paintings □ 2. Graphics JSJ 3. Photography
□ 4. Sculpture □ 5. Crafts
Materials
P/Zofii i © A
in\A?KT^<f ^ oUje C r
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Title
Price or NFS
Insurance Value
Size
If NFS Only
l<*K5-0
GRAPHICS AND PHOTOGRAPHY ONLY
Additional No.
Total No. in Edition
Price
Price of
For Sale .
-^o
Unframed
loo
Frame ^
ACCEPTED
REJECTED
DO NOT WRITE IN
THIS SECTION
ACCEPTED
REJECTED
RECEIVED
MKl
DATE
¥
0